Prevent Childhood Poisoning: 5 Surprising Dangers
U Virginia, School of Med. | 2018-07-17 12.27 Prevent Childhood Poisoning_ 5 Surprising Dangers
Hello, everyone and welcome to the webinar– “Prevent Childhood Poisoning– Five Surprising Dangers.” It’s presented by the Blue Ridge Poison Center at the University of Virginia Health System and was recorded in July of 2018. I’m Kristin Wenger, the education coordinator. This presentation will last about 20 minutes . At the end, you’ll be shown a link to a brief anonymous survey to check your understanding and get your feedback. And at the end of the survey, you’ll have an opportunity to print or save a certificate of completion.
First, a quick note about poison centers. Many people are surprised to learn that there is more than one. In fact, they are 55 in the whole country and three in Virginia. My center, the Blue Ridge Poison Center, serves all of the counties that are shaded in white on this map. However, the toll free number is the same all across the country. If you live in the Blue Ridge Poison Center coverage area, I’ll explain later how you can order free materials from us such as magnets or stickers or posters. If you don’t live in our coverage area, don’t worry, I can help connect you to the poison center that provides materials in your area. But regardless of where you live, that’s the only number that you need, and it works everywhere in the country routing the call to the center assigned to that area.
Thanks again for sharing 20 minutes of your time with me today. Here’s what I plan to discuss. What are the risks for poisoning in young children. I’m going to show you five products that are surprisingly dangerous. I’m going to share tips for poisoning prevention so that you can keep young children safe. And I’m going to tell you what to do if an accident happens and someone has been exposed to something harmful. The poisoning risks for young children are different than the risks for a teenager or an adult or a senior adult.
Young children are very curious. They get into everything. They open cabinets and drawers. They turn over trash cans, they go digging around in mom’s purse. They have immature taste buds, so they don’t always spit out something just because it tastes bad. Everything they touch goes right into the mouth. And they imitate the behavior of the adults around them. So if they see you using a cleaning product or taking medicine, they may want to try to imitate that behavior themselves.
Parents and caretakers sometimes make mistakes, such as giving a child the wrong dose of medicine. And children are very susceptible to look-alike mistakes. Let me show you what I mean. Here are some common look alike dangers, including liquids that look just like juice or Kool-Aid or sports drinks. Plants, mushrooms, and berries found growing outside look just like the edible ones we feed to our children. And pills look just like candy to children.
Given all the risk factors, I just mentioned the number one best way to prevent childhood poisoning is to keep harmful things up and away out of their sight and reach. If they can’t see it and they can’t reach it, they can’t get
into it. Do you have a little climber in your home? Try to find a high place that is not within easy reach of chairs or counters or other means by which a child could access it by climbing. When I was a toddler, I famously climbed on top of the toilet to open the medicine cabinet. Luckily, my mother caught me just in time.
So you may want to consider using a lock in addition to keeping products up and away. And in fact, you can buy special containers for medicine or cleaning products that have locks on them. There’s many, many different kinds out there. All right, now, I’m going to introduce you to five products that either you may not have realized were potentially harmful or could result in injuries so severe, they might even be deadly, in only small amounts. Number one on my list– button batteries, also known as disk batteries.
These are found in many products, including remote control devices of all kinds, talking books, singing greeting cards, hearing aids, flashing jewelry and ornaments, games, and some toys. Young children are very attracted to them because they’re shiny and they’re really little. They’re easy to swallow, and they’re easy to put into the nose or the ear. Most of the time, when a child swallows any foreign object, whether it’s a battery, a coin, or a Lego, the object passes through the gut and comes out the other end in a day or so. But occasionally the object gets stuck in the esophagus or the throat. When that happens, the prolonged contact could give the battery a chance to leach out a toxic chemical which causes burns.
In this X-ray, you can see a button battery stuck at the top of a child’s throat. The picture on the right is courtesy of our colleagues at the Illinois Poison Center, so I really appreciate them sharing this image with us. They inserted a button battery into a hot dog and then cut it open three hours later. See the burns? Imagine if this was your child’s throat. In addition to keeping batteries up and away, other prevention tips include– use duct tape to secure the battery panel of your remote control devices; avoid changing batteries in front of children, and also avoid letting them watch you dispose of the used ones because they may go hunting around for them later. If anyone in your home uses hearing aids, give them a safe place to store their new and their used batteries because hearing aid users go through a lot of batteries in a short time.
Dangerous item number two– transdermal patches, sometimes called skin patches. These are medicated adhesive patches placed on the skin, which provide a very slow, steady release of small amounts of medicine over time right through the skin into the body. Many drugs are available in patch form, including hormone replacements, birth control, nicotine– to help people stop smoking– motion sickness drugs, and drugs that treat chronic severe pain. These are great products but they could be dangerous to young children because they resemble harmless items that children love, such as stickers or band-aids.
There are numerous cases of children finding the patches and sticking them all over their body. And even a used patch may still have enough residual medicine in it to cause harm to a small child. Children will also put them in
their mouths. One little girl was found with six transdermal patches stuck to the roof of her mouth. It took the medical team a long time to figure out why she was unresponsive. Look at that top right photo.
It’s easy to see the foil pouch wrappers, but can you see the actual patches themselves? Look closely– they are clear, which is great if you’re an adult and trying to disguise a patch on your own body. But they will be difficult to see if a child has found one and applied that to their own body. In addition to keeping patches up and away, other prevention tips include, checking periodically to make sure your patch is still in place, especially after sleeping, changing clothes, or bathing. After removing a patch, fold it in half so that it sticks to itself before throwing it away, thereby, trappings of medicine inside.
And some manufacturers recommend flushing the patch instead of disposing it in a trash can if you have young children in your home because children might retrieve the discarded patch from a trash can. Remember, even a used patch may still have enough residual medicine in it to cause harm to a small child. Dangerous item number three– e-liquid or vape juice. This is the liquid inside of an e-cigarette or vaping device. Many of these products contain nicotine, which is very toxic. In high doses, in fact, nicotine can cause nausea, vomiting, dizziness, seizures, and even death.
Nicotine can cause these symptoms when inhaled as a vapor or smoke or when swallowed or even when absorbed through the skin. It could take as little as one teaspoon of liquid to be life threatening for a small child. By the way, as you know, conventional tobacco products like cigarettes and pipes and cigars, they contain nicotine also. If a child swallows as little as one whole cigarette or three cigarette butts, that could be a serious nicotine poisoning also.
Look at these pictures, e-liquid comes in many sweet or fruity flavors, which are very attractive to young children. And even the packaging is attractive– it looks like it contains candy or other delicious treats. Many e-cigarettes and vaping devices themselves resemble toys, lipstick, ink pens, et cetera. The JUUL, on the far right there, is very tiny and looks just like a USB drive for your computer. In addition to keeping e-liquid up and away, other prevention tips include– check with your guests, you may need to give visitors a safe place to store their purses or other belongings. Use caution when refilling a device, avoid skin or eye contact with the liquid.
Don’t transfer the contents of a refill bottle into any other container and don’t reuse empty refill bottles for any other purpose. Lastly, store these products in a separate location away from food or medicine to help prevent a mistake. Dangerous item number four– eye drops. Not all eye drops and no one particular brand. Rather any eye drops with one particular ingredient– tetrahydrozoline. When tetrahydrozoline is in your eyes, it constricts the blood vessels, which reduces redness. But if you swallow it, it can cause nausea and vomiting, a dangerous drop in blood pressure, a dangerous lowered heart rate, and in severe cases, it can lead to coma or death and as little
as a teaspoon could be harmful to a small child.
Eye drops do not usually come in child resistant containers, and we tend to store them within easy reach of a child, such as in a purse or on the bathroom counter. Like all products, it’s important to keep eye drops up and away. And if children are in your home, you may wish to consider purchasing drops without the tetrahydrozoline ingredient just until they are a little bit older. The last of the five dangers are these concentrated laundry detergent packets, sometimes called pods. These are attractive to kids because they look like candy or teething rings or toys.
Exposure to conventional liquid or powder laundry detergent is very common, but that usually results in only minor symptoms– it’s rarely serious. There’s something about the concentrated pods though which is different. The pods are designed to dissolve when wet such as in your child’s mouth or a child could bite down and squeeze one and pop it open easily. Some children who have swallowed the contents of a pod have experienced excessive vomiting, wheezing and gasping. There are reports of children becoming unconscious and some have had breathing problems serious enough to need a ventilator to help them breathe. Also some children have experienced corneal abrasions when the detergent got in their eye.
The product was introduced to US markets in 2012 and calls to poison centers about problems with the pod’s began almost immediately and continued to rise sharply as the products became more popular. Eventually, manufacturers responded by creating safer packaging. You see the image on the left– that’s the old style of package. The image on the right where the woman is placing the container in a high cabinet– that shows the new style. The container is now opaque so you can’t see through it and see what’s inside, thereby, resisting temptation.
Also, they come in child resistant containers now, so that the lid is harder to open. And, of course, there are warnings on the label. Still, the best prevention measure is to keep them up and away. Also, don’t use them if you plan to set a timer on your laundry machine. So if you put one into the soak compartment and then set the timer and walk away, later, your child may come along behind you and open up the soap panel and discover the pod. In fact, you may wish to consider switching to traditional liquid or powdered laundry detergent just until your children are a little bit older.
I have to mention the “Tide Pod challenge,” quote unquote. I’m sure you’ve heard of it. This is a recent cultural phenomenon where teens and adults would film themselves biting into a pod, which resulted in gagging, choking, drooling, even vomiting sometimes, and then posting the images online and challenging others to try it too. There are literally thousands of these videos online. Many people were injured badly enough to need medical care. Now, preventing teens and adults from intentionally doing something harmful is a whole other presentation. We’ll have
to save that for another day.
Meanwhile, we’re here to talk about preventing childhood poisoning today and remember that young children are little copycats. And they will imitate the behavior of what they see others do. All right, prevention does work. However, we are human. We make mistakes. We cannot control everything around us all the time. As you know, children are quick and they are unpredictable. It’s important to be prepared and know what to do in an emergency.
If someone has been exposed to something potentially harmful, first, do not induce vomiting. Don’t Google the problem– the internet is notoriously inaccurate when it comes to medical advice. Instead, call poison control right away. You don’t have to wait for any symptoms to develop. Symptoms do not always occur right away in the event of a poisoning. Why call the poison center? Well, we’re open all the time so you can call us 3 o’clock in the morning, you can call us on Christmas day, and we’re open. And, in fact, a real live human will answer the phone and the person who answers the phone is the nurse or physician with expert training to handle poisoning exposures of all kinds.
We are completely free and completely confidential. There is no question too bizarre or too small. And you can even call us with your non-emergency questions. The poison center does save lives because our experts have the most up to date current effective treatment advice for handling all kinds of poison and exposures, but we save money too because much of the time, we’re able to tell you what to do to take care of your poison and exposure at home instead of rushing in to the hospital.
We encourage you to program the number into your smartphone, so you can find it quickly and easily. And to make it an easy task, all you have to do is text the word poison to 797979 your smartphone, and the number will automatically save itself into your contact list. We also encourage you to get in touch with me or your poison center and order some free magnets or stickers or other things so that you can keep the number handy at all times.
I’m excited to share a new tool with you– www.poisonhelp.org. And poison help is all one word. It’s a new website designed by toxicologist and poison center specialists that you can visit for advice if you think someone may have been exposed to something harmful. It is free and confidential just like our phone service. If your exposure is complicated or potentially serious, you’ll be directed to the toll free number so that you can talk to a specialist about your unique situation. But going to the website may be a great place to start.
Here on one screen are all the important numbers I talked about today. In summary, 1-800-222-1222 connects you instantly to a poison center and that number works everywhere in the country. You can text the word poison to 797979 to have the number saved into your smartphone. www.poisonhelp.org is a new website that you can
visit to answer a few questions about a poisoning exposure to get advice about what to do. And www.brpc.virginia.edu the website of the Blue Ridge Poison Center where you can get in touch with me to order free materials or get other information.
At the bottom of your screen is my personal contact information in case you need to contact me about education or outreach. You may wish to take a screenshot of the slide or pause the presentation so you can write all this stuff down. And just a reminder, the very next slide is going to present you with a link to an anonymous survey so we can get your feedback about today’s presentation and also see if we were successful in helping you learn anything. The last page of the survey will provide you with the link to a certificate of completion. Event if you don’t want the certificate, please fill out the survey it only has a few very quick true/false multiple choice questions and your feedback matters a great deal to us. Thank you in advance, have a great day.